| |
6556 S Big Cottonwood Canyon Rd, Salt Lake Cty, UT 84121-3580 | |
(435) 553-5698 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Dietitian, Registered |
Location | 6556 S Big Cottonwood Canyon Rd, Salt Lake Cty, Utah |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831616630 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
6556 S Big Cottonwood Canyon Rd, Salt Lake Cty, UT 84121-3580 Ph: () - | 6556 S Big Cottonwood Canyon Rd, Salt Lake Cty, UT 84121-3580 Ph: (435) 553-5698 |